Interactions

Interactions with Drugs

The effects of anticholinergic drugs may decrease when used in combination with betel nut or its constituent arecoline. Use with cholinergic drugs may cause toxicity (salivation, increased tearing, incontinence, sweating, diarrhea, vomiting, or fever). Betel nut may slow or raise the heart rate and could alter the effects of drugs that slow the heart, such as beta-blockers, calcium channel blockers, or digoxin.

Betel nut may alter blood sugar levels. Caution is advised when using medications that may also alter blood sugar. Patients taking drugs for diabetes by mouth or using insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

Other medications that betel nut may interact with include: antibiotics, medications that alter blood pressure, anti-inflammatory medications, or medications taken for cancer or immunosuppression. Patients taking anti-psychotic drugs should use cautiously due to reports of increased side effects. Based on the way betel nut is processed in the body, there may be interactions when taken with muscarinic antagonists. Furthermore, chronic use of betel nut and alcohol may lead to an increased risk of oral cancer.

Betel may alter blood sugar levels. Caution is advised when using herbs or supplements that may also alter blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Betel may inhibit monoamine oxidase and therefore may increase the effects of herbs and supplements that may also inhibit monoamine oxidase. Betel nut may also interact with cardioactive agents, such as hawthorn or oleander, or agents that effect thyroid levels, such as bladderwrack.

Betel may cause stimulant and euphoric effects and add to the effects of stimulants such as caffeine, guarana, or ephedra (ma huang).

Betel has been reported to deplete an essential vitamin (thiamine) and theoretically may cause neurologic damage including Wernicke-Korsakoff syndrome (confusion, poor muscle coordination, eye movement problems, and amnesia). Based on human study, chewing betel nut may aggravate the effects of vitamin D deficiency. Theoretically, simultaneous long-term use of betel and alcohol may lead to an increased risk of mouth cancer.

Other herbs or supplements that betel nut may interact with include antibacterials, agents that alter blood pressure, anti-inflammatory agents, or agents taken for cancer or immunosuppression. Patients taking herbs with antipsychotic effects should use cautiously due to reports of increased side effects. Based on the way betel nut is processed in the body, there may be interactions when taken with herbs with muscarinic antagonists effects as well.